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Custom program developed for Health Science leaders

Health Sciences Leadership Series

A program designed to improve the leadership capabilities and communication skills of Health Sciences faculty members.

Visit the Faculty of Health Sciences website to register.

By Mark Kerr, Senior Communications Officer

Health Sciences faculty members spend years training for their roles as educators, researchers and scholars. In many cases, though, there aren'™t the same opportunities to develop specific skills required for their administrative and managerial duties.

The Office of Faculty Development in the Faculty of Health Sciences aims to change that by collaborating with the Human Resources Department on a new management development program. The Health Sciences Leadership Series will launch this September with the first cohort of 30 participants completing six full-day sessions throughout 2014-15.

"This program is modelled after one that myself and a number of other faculty had the opportunity to take several years ago," says Tony Sanfilippo, Associate Dean, Undergraduate Education, Faculty of Health Sciences. "In retrospect, the content has proven to be highly relevant and practical. The Health Sciences Leadership Series will be invaluable to any faculty members charged with administrative responsibilities or curricular development."

Human Resources designed the program specifically for Health Sciences faculty members. The material will cover challenges, situations and conflicts they will encounter in their day-to-day work. Dr. Sanfilippo says participants will gain a deeper understanding of their leadership capabilities, expand their communication skills, enhance their project management skills, and improve their ability to build relationships both within and outside their department.

The Health Sciences Leadership Series will be invaluable to any faculty members charged with administrative responsibilities or curricular development.

Tony Sanfilippo, Associate Dean, Faculty of Health Sciences.

With the Health Sciences Leadership Series, Queen's Human Resources Department continues to expand its leadership development programming. The department has offered a similar program for non-academic managers since 2009.

"œWe are excited to partner with the Faculty of Health Sciences to extend this valuable leadership training to their faculty members," says Al Orth, Associate Vice-Principal, Human Resources. "We are hopeful that the positive outcomes of this series will result in opportunities to work with other faculties on similar programs in the future."

The series has the added benefit of meeting the accreditation criteria for two professional organizations. It is an accredited group learning activity for the Royal College of Physicians and Surgeons of Canada. The program also meets the accreditation criteria of the College of Family Physicians of Canada.

Online registration is now open with the first session slated to take place Sept. 16. More information is available on the Faculty of Health Sciences website or by contacting Shannon Hill, Learning Development Specialist, Human Resources, at ext. 74175.

Diabetes on the rise in First Nations populations

New report shows the disease has reached an all-time high within Canada’s First Nations communities, impact on children is concerning.

A first-of-its-kind, First Nations-specific report, co-authored by Queen’s University professor Michael Green, shows the number of First Nations people in Ontario living with diabetes is at an all-time high at 14.1 per cent.

According to the report, developed jointly by the Chiefs of Ontario (COO) and ICES, the increase is particularly concerning as there is a rising, disproportionate number of First Nations children affected by diabetes.

Research at Queen's
Did you know that the university recently launched a new central website for Queen’s research? From in-depth features to the latest information on the university’s researchers, the site is a destination showcasing the impact of Queen’s research. Discover Research at Queen’s.

“Lower monitoring, lower levels of diabetes control and less access to primary care mean First Nations people are more likely to experience complications of their diabetes at an earlier age and sooner after their diagnosis which is why focusing on prevention is key to making to changes to how diabetes affects First Nations people,” says Dr. Green, professor in the Departments Family Medicine and Public Health, and a senior scientist at ICES.

First Nations and Diabetes in Ontario takes a detailed look at diabetes and its consequences on First Nations people in Ontario from 1990 to 2014. The data presented in the report highlights specific inequalities and supports the development of effective health policies and programs to prevent diabetes in First Nations people.

The researchers highlight that the three dominant individual risk factors for type 2 diabetes among First Nations people living in First Nations communities are physical inactivity, weight/obesity and smoking. However, efforts to address these risk factors must consider the cumulative effects of ongoing racism, dispossession from land, childhood and intergenerational trauma, changes in diet and an increase in sedentary lifestyles associated with colonization.

The report found that in 2014/15, 39.3 per cent of First Nations people living in First Nations communities had good control of their blood sugar, compared to 56.5 per cent of other people in Ontario.

“This report is a step in the right direction to fill information gaps which have led to health policy gaps. This report builds on relationships and formal agreements to understand Indigenous health today, and in order to do that we have to know Indigenous history, government relations with Indigenous people, and the collective that the people have experienced,” says report co-author, Jennifer Walker (Laurentian University), the Canada Research Chair in Indigenous Health and the Indigenous Health Lead at ICES.

A series of studies, including this one, are being published in the journals CMAJ and CMAJ Open. These studies are the start of a series of papers on diabetes and First Nations health. They are part of a partnership between researchers and COO which engages First Nations patients, families, elders and community members in the project.

The research was funded by the Ontario SPOR SUPPORT Unit.

Major upgrade for MRI facility

Queen’s University announces new state-of-the-art equipment for Centre for Neuroscience Studies.

[The new 3 Tesla MRI for the Centre of Neuroscience Studies]
The Centre for Neuroscience Studies recently unveiled its state-of-the-art MRI machine, a Siemens Magnetom 3T Prisma, the most powerful 3 Tesla whole body MRI on the market. 

Keeping up with the fast pace of technological advancements in the neuroimaging field, the Centre for Neuroscience Studies (CNS) at Queen’s University recently unveiled the latest state-of-the-art MRI machine, the Siemens Magnetom 3T Prisma. The Prisma is a next generation, whole-body scanner and is a major upgrade to the centre’s current system.

“A research-dedicated MRI facility is an essential component to any research-intensive neuroscience program, allowing investigators to study the structure and function of the living human brain in remarkable detail,” says Dr. Roumen Milev, Director of the CNS. “This is the most powerful 3 Tesla MRI on the market, allowing for high precision imaging of smaller tissues and enhanced tracking of brain connectivity.”

[Brain scan using the 3 Tesla MRI]
Using the Centre for Neuroscience Studies' new Prisma MRI, 30,000 white matter tracts are revealed through diffusion spectrum imaging (DSI).

With the support of the Canadian Foundation for Innovation, the CNS MRI facility first became operational in 2005. Over the last 14 years, approximately 6,000 participants have been imaged for over 140 different research projects – leading to hundreds of research papers and important findings.

Research goals have spanned the spectrum from answering important fundamental questions about brain function and organization, to large multi-site studies searching for biomarkers of disease, to industry-sponsored clinical trials. A wide variety of disorders and diseases have been studied, including Alzheimer’s disease, Parkinson’s disease, Amyotrophic Lateral Sclerosis (ALS), epilepsy, Attention Deficit Hyperactivity Disorder (ADHD), Fetal Alcohol Spectrum Disorders (FASD), spinal cord injury, and fibromyalgia.

“In recent years, the facility has been an integral part of many large multi-site initiatives, involving partners such as the Ontario Brain Institute (OBI) and Kids Brain Health Network (KBHN),” says Dr. Milev, speaking to direct patient impact. “These initiatives allow us to collect large numbers of participants throughout Ontario and the country, exploring the brain mechanisms that underlie neurodevelopment, neurodegeneration, and neuropsychiatric illness, and potentially finding biomarkers of related disorders.  These studies impact not only our understanding of the biology of these disorders, but lead to the formulation of early detection tests, as well as translating our research to the clinic.”

The CNS MRI Facility has also recently been renovated, outfitting the facility with high-performance computers and cutting-edge monitoring equipment and devices.

“The new facility will allow us to be competitive with any imaging centre in the world for the next decade and beyond and help further cement Queens’ reputation as a top-tier center for neuroscience research” Dr. Milev adds.

For more information visit the CNS website.

[Ribbon cutting for Centre for Neuroscience Studies new MRI]
The Centre for Neuroscience Studies recently installed a state-of-the-art MRI system, the Siemens Magnetom 3T Prisma. A special ribbon cutting brought together: Christopher Simpson Vice Dean (Clinical), School of Medicine; Jill Atkinson, Associate Dean, Faculty of Arts and Science; Patrick Deane, Principal and Vice-Chancellor; Kim Woodhouse, Interim Vice-Principal (Research); and Roumen Milev, Director, Centre for Neuroscience Studies. (Supplied photo)


Forging a new path for medical students

Queen's medical student Thomas Dymond changed the course of his education to focus on Indigenous health.

Medical students Thomas Dymond with Ann Deer, a Indigenous Recruitment and Support Coordinator at Queen’s.
Medical student Thomas Dymond (left) with Ann Deer, an Indigenous Recruitment and Support Coordinator at Queen’s.

This year, Thomas Dymond became the first-ever student in the Queen’s School of Medicine to do an extended clinical rotation in an Indigenous community, under the supervision of an Indigenous physician, caring for Indigenous patients. However, his path to doing so was not always clear – in fact, he charted an entirely new one that could change the way Queen’s medical students approach their upper-year clerkships.

Dymond, who is Mi’kmaq from the Bear River First Nation in Nova Scotia, hasn’t always found his medical school experience to be easy. Last year, he took time away from his studies because of stress, and began to feel uncertain about whether he would complete his degree.

During this time of uncertainty, he reached out to Ann Deer, an Indigenous Recruitment and Support Coordinator at Queen’s, who connected him with Dr. Ojistoh Horn, a Mohawk family physician in the Indigenous territory of Akwesasne – a community of 14,000 people that straddles the borders of Ontario, Quebec, and New York state.

Thomas Dymond did his clerkship under the supervision of Dr. Ojistoh Horn, the sole full-time physician in Akwesasne.
Thomas Dymond did his clerkship under the supervision of Dr. Ojistoh Horn (left), the sole full-time physician the Indigenous community of Akwesasne.

Soon after reaching out to Dr. Horn, Dymond arranged to do a four-week elective – a precursor to clerkship – in Akwesasne. Dr. Horn, the sole full-time physician there, regularly works with visiting medical students to care for patients at a variety of clinics, on home visits, and at a long-term care facility. Thomas spent a month working alongside her, and for the first time, felt like he had found his place in medicine.

“The elective revitalized me mentally, physically, emotionally, and spiritually,” says Dymond. “I felt lifted up, like I was contributing, learning, and engaging. I wasn’t just giving back, I was also getting something out of it.”

A return to studies

At the end of his elective, Thomas knew he wanted to return – not only to his studies – but to this community he had come to adore. His biggest obstacle: there was not yet an approved path to completing his longitudinal integrated clerkship in Akwesasne. Newly invigorated, Dymond pushed onward.

With Dr. Horn’s support, Dymond drafted a letter to the Director of Clerkship and the Assistant Dean, Curriculum. In it, he made a passionate case, detailing how he would meet all of the curricular requirements for his pediatrics, family medicine and psychiatry clerkship courses by spending his four-month integrated rotation in Akwesasne, and laid out his plan.

“I wanted to go back to Akwesasne, but I also wanted to change clerkship, to change the system, to change medicine,” he says.

Returning to Akwesasne

He knew that it was an atypical request, and was fully prepared for the school to say no. Instead, his letter was acknowledged and passed along to Dr. Shayna Watson, Director of the Integrated and Family Medicine Clerkships, who was in immediate support of Dymond’s request. There were hurdles to be overcome in a short period of time – Dymond’s request was made only two months before his clerkship was to start – but she committed to making it happen.

Just before his clerkship was set to start, Dr. Watson confirmed that Dymond’s request to go to Akwesasne and work with Dr. Horn had been approved. Dymond is now completing his clerkship rotation at Akwesasne, and he could not be happier.

“I feel like I am fully supported for who I am,” says Dymond, “both an Indigenous person and a medical student.”

Thomas worked hard to forge a path for other Indigenous students in the School of Medicine, and his clerkship has broken new ground. While he navigates the challenges of establishing a new clerkship, he is setting a path for others, and helping to build an important relationship between the School of Medicine and the community of Akwesasne.

“As we work to Indigenize the school of medicine’s curriculum, forming relationships with nearby Indigenous communities is a crucial step,” says Dr. Leslie Flynn, Vice Dean Education, Faculty of Health Sciences, “Thomas is an exceptional student, and I am thrilled that he took the initiative to make this happen. He has led the way to enhancing our community partnerships.”

National honour for international research impact

Queen’s University researcher inducted into the Canadian Academy of Health Sciences for scientific advancements in the treatment of bowel disease.

Queen’s University professor of medicine Stephen Vanner has been named a Fellow of the Canadian Academy of Health Sciences (CAHS).

[Stephen Vanner speaks about his research]
Stephen Vanner, director of the Gastrointestinal Diseases Research Unit (GIDRU) at Kingston Health Sciences Centre and Queen’s, has been named a Fellow of the Canadian Academy of Health Sciences.

One of Canada’s most prestigious honours, Fellows are chosen for their international leadership, academic performance, scientific creativity and willingness to serve.

The academy describes Dr. Vanner, director of the Gastrointestinal Diseases Research Unit (GIDRU) at Kingston Health Sciences Centre and Queen’s, as “an internationally recognized clinician-scientist whose work in bowel disease laid the foundations of the new field of neurogastroenterology.” They add that “his discoveries have advanced understanding of bowel disease and improved patient outcomes worldwide.”

“I’m deeply honoured to be recognized by the academy in this way,” says Dr. Vanner, also a clinician-scientist at KGH Research Institute. “For more than 30 years, my research and related volunteer activities have been guided through the lens of ‘yes, but what are our patients telling us?’, because I believe that engaging patients in research leads to better treatments and better outcomes.”

He is cited for his work in transforming the GIDRU into one of the top facilities of its kind in Canada, and for his pioneering role in engaging patients in his research. Dr. Vanner has also served in leadership roles on national gastroenterology and related patient advocacy organizations, and at the grassroots level has been a thoughtful and articulate voice for patients and the public. Internationally he is a member of the prestigious Rome Foundation Committee, helping to develop global guidelines for bowel disease.

More recently he was named co-lead investigator on Canada’s largest-ever study of bowel disease, comprising 88 researchers and 17 centres across Canada. This groundbreaking initiative is targeting diet, gut bacteria, and mental health with an aim of developing new treatments that improve both the physical and mental health of sufferers of irritable bowel syndrome and inflammatory bowel disease.

“Dr. Vanner is an exceptionally talented researcher and a passionate advocate for the role of patients in his research,” says Steven Smith, Vice President, Health Sciences Research, KHSC, Vice-Dean (interim) Research, Faculty of Health Sciences, Queen's University and President and CEO, KGH Research Institute. “As well, he is a gifted mentor to his students and trainees – indeed, during his time at Queen’s and KHSC, at least 50 new gastrointestinal clinician-scientists have benefited from his training and guidance, and several of these are now considered research ‘stars’ in their own right. Stephen represents the absolute best of the academy’s values. We extend our warmest congratulations to him on receiving this well-deserved honour.”

For more information on the Canadian Academy, visit the website.

Two-Spirit physician visits Queen's to discuss decolonizing medicine

New lecture series debuts with expert in Indigenous and LGBTQ2+ health.

James Makokis (centre) standing with lecture series supporters M. Nancy Tatham (left) & Donna Henderson (right).
Lecture series supporters M. Nancy Tatham (left) and her partner Donna Henderson (right) pictured with guest speaker James Makokis.

A new lecture series promoting equity, diversity, and inclusivity in medical education debuted with a talk by James Makokis, a family physician from Saddle Lake First Nation in Alberta who leads one of North America’s most progressive and successful transgender-focused medical practices.

“Indigenous youth have one of the highest rates of suicide in the country, and that rate increases even further when we look at transgender members of that group,” said Dr. Makokis to an audience that packed the Britton Smith Lecture Theatre and a second, overflow space at the Queen’s University School of Medicine. “Every family medicine physician has within their scope of practice a general medical license that gives them the ability to provide transgender care. Medical students and residents, take time to learn to do this in your practice. It will be one of the most fulfilling areas of your career and you will help save lives.”

His lecture, entitled Decolonizing Medicine: Creating an Inclusive Space for Transgender and Two-Spirit People, is the first in the newly-created Dr. M. Nancy Tatham & Donna Henderson Lectureship – a series of talks featuring scholars and experts from diverse backgrounds discussing inclusivity in health, with a particular focus on LGBTQ2+ and Indigenous issues.

Dr. Makokis, who is both Cree and Two-Spirit, discussed language used around gender in medicine, the history of gender and First Nations people, and access to transgender care and hormone therapy. He explained that ideas of transphobia and homophobia are colonial social constructs, and argued that decolonizing medicine can be achieved through simple acts, like acknowledging and accepting LGBTQ2+ patients and providing care that meets their needs.

“Take off your white lab coats,” he said. “It holds so much institutional symbolism, but it can also serve as a barrier. Take it off and seek to relate to your patients in a human way. I guarantee this will help you have a long, healthy, and happy medical practice and career.”

Supported by a donation from Dr. Tatham and Ms. Henderson, who are both long-time activists, the lectureship is organized by the School of Medicine’s undergraduate Diversity Panel. Students on the panel expressed a deep enthusiasm in putting Dr. Makokis forth as the first speaker in the series.

“Understanding the impacts of the historical and ongoing oppression faced by our patients is so essential in being able to provide excellent care,” says Ayla Raabis, Queen’s medical student and Diversity Panel member. “We must constantly strive to undo our own biases to be able to truly connect and ensure we are seeing our patients as the complex people we are tasked with caring for. Dr. Makokis’ talk was such a valuable opportunity to learn from his unique personal and professional experience, and to inspire us to push for making medicine a safe space for all patients.”

Notably, Dr. Makokis and his partner Anthony Johnson won the most recent season of well-known television competition The Amazing Race Canada. They were praised for using the platform to raise awareness of Two-Spirit people.

The October 23 talk from Dr. Makokis was the first in the new annual lecture series. Information on future Dr. M. Nancy Tatham & Donna Henderson Lectureship talks will be shared on the School of Medicine website.

“We're excited to carry the momentum of this talk forward by hosting additional events centred around improving access to healthcare and delivering culturally-informed care to LGBTQ2S+ and Indigenous populations,” says Danny Jomaa, Queen’s medical student and member of the Diversity Panel. “As trainees in medicine, it's important for us to build approaches to care that are formed on the principles of equity and respect for marginalized groups.”

Harnessing microbes to treat gut pain

Queen’s University researcher receives funding to help those suffering with pain from inflammatory bowel disease.

The digestion of food is a complex process and millions of different types of bacteria are  one part of the process that help get the job done

That said, there are a number of bacterium present in a healthy bowel that perform the unexpected function of helping suppress gut pain. Queen’s University researcher (Department of Medicine and Department of Biomedical and Molecular Sciences) Alan Lomax is studying how that bacterium could be the secret to suppressing pain for people living with inflammatory bowel disease (IBD).

To support the five-year project, Dr. Lomax, who is also scientist at Kingston Health Sciences Centre’s Gastrointestinal Diseases Research Unit, has been awarded $790,000 from the Canadian Institutes of Health Research (CIHR) to study how the presence of some human gut microbes can help modulate the pain of IBD such as Crohn’s disease and ulcerative colitis.  Canada has the highest rate of IBD in the world.

The project builds on his group’s discovery that the pain suppressing bacterium is present in healthy bowels.  This bacterium is missing in many patients with IBD, which may remove a brake on the pain that these patients experience. Their research has also shown that other gut microbes from patients with IBD can produce substances that cause pain.

“A number of studies have showed that this pain-relieving bacterium is absent in patients with IBD,” says Dr. Lomax.. “We’ll identify what chemicals those bacteria are producing, and whether those secretions could be used to relieve pain.”

The research team will also use metagenomics analysis to understand how the changes in microbiota in patients with IBD lead to worsening pain. Ultimately the researchers hope to develop a microbe-based treatment for IBD that is a safer and more effective alternative to existing opioid pain medications.

The study is part of a growing body of research that has linked gut microbes to several illnesses including depression, anxiety, diabetes, autism, and even cancer.

“These bacteria have all sorts of influences around the body,” Dr. Lomax says. “The more we understand about how these microbes affect health, the more we can move towards designing new treatments that target these microbes.”

For more information on research at Queen’s, visit the new Queen’s Research website.

Exploring bones and joints in action

Skeletal Observation Lab provides insight into every joint in the human body.

The capabilities of the new equipment is demonstrated during the opening. Photo credit KHSC

Researchers at Queen’s University and Kingston Health Sciences Centre (KHSC) are celebrating the completion of a $2.5 million facility that offers unique, X-ray vision insights into the biomechanics of nearly any joint in the human body.

While advances in orthopedic medicine have improved the mobility of humans worldwide, the precise workings of our skeleton and its joints are still notoriously difficult to understand, particularly when in motion.

The Skeletal Observation Laboratory (SOL), a facility supported by Queen’s and KHSC at the Hotel Dieu (HDH) site, is helping to fill that gap. One of only a few such labs in Canada, it offers leading-edge technologies for capturing, in exquisite detail, how the machinery of our bones and joints work when they’re in dynamic action.

During the opening event, Michael Rainbow, the lab’s lead investigator and assistant professor of Mechanical Engineering at Queen’s, and David Pichora, orthopedic surgeon and president & CEO of Kingston Health Sciences Centre, demonstrated the new, ultra low-dose, load-bearing CAT scanner. Unlike conventional CT machines, which require patients to lie down, with no load on their joints, this scanner can perform 3D scans while the person is standing.

A closer look at the new equipment. Photo credit KHSC

The lab is helping doctors and scientists develop new treatments and preventative strategies tailored to individual bone and joint disorders.

Dr. Rainbow demonstrated how the lab’s powerful imaging equipment – such as high-speed X-ray, and high speed video capable of 1,000 frames per second – helps him explore the complex machinery of foot function during walking and running.

“Better understanding of this complicated network of bones and joints will lead to better designed footwear, prosthetics and orthotics for patients,” he says.

The Skeletal Observation Laboratory is a satellite facility of the Human Mobility Research Centre at KHSC’s Kingston General Hospital site. It is co-located at HDH with the Human Motion Research Lab and the Queen’s Centre for Neurosciences clinical lab, enabling patient-oriented “research from brain to joints.” 

Funders of the Skeletal Observation Lab and its research include the Canada Foundation for Innovation (CFI), Canadian Institutes of Health Research (CIHR), Natural Sciences and Engineering Research Council (NSERC), Queen’s Faculty of Engineering and Applied Science and Department of Mechanical and Materials Engineering, The Estate of Donald McGeachy, BSc (Mech Eng) 1940 and University Hospitals Kingston Foundation (UHKF).

An Inuit approach to cancer care promotes self-determination and reconciliation

Cancer rates are rising among Inuit and critical oncology specialists and treatments are often located in urban centres, thousands of kilometres away from remote communities in Inuit Nunangat. (Alex Hizaka), Author provided

For thousands of years, Inuit have adapted to the changes in their environment, and continue to find new and innovative ways to survive.

But life expectancy among populations in Inuit Nunangat (the traditional territory of Inuit in Canada) is an average of 10 years less than that of the general Canadian population.

Cancer is a leading cause of this disparity. Inuit experience the highest mortality rates from lung cancer in the world, and mortality rates of some other cancers continue to increase disproportionately.

Inuit communities tend to be self-reliant and are renowned for working together for a common goal, which is evident in their self-governance and decision-making activities. They have also endured a long history of cultural insensitivity and negative health-care experiences that span generations


Map of Inuit Nunangat (Inuit Regions of Canada)

The ways the Canadian health-care system interacts with Inuit populations plays an important part in this health disparity. And there is an urgent need for Inuit to be able to access and receive appropriate health care.

In 2015, the Truth and Reconciliation Commission of Canada (TRC) report made 94 recommendations in the form of Calls to Action. Seven of these Calls to Action specifically relate to health. They explain the importance of engaging community members, leaders and others who hold important knowledge in the development of health care.

As members of a team of Inuit and academic health-care researchers, we have been working with health-system partners to support Inuit in cancer care. We focus on enhancing opportunities for Inuit to participate in decisions about their cancer care through the shared decision-making model, in a research project we call “Not Deciding Alone.”

We travel thousands of miles for cancer care

Our collective success in addressing the TRC Calls to Action will require health research to focus on addressing the health-care inequities experienced by Inuit, First Nations and Métis populations in ways that take action to promote self-determination.

This is important as current health-care models do not often support Indigenous values, ways of knowing and care practices.

Poor cultural awareness in our mainstream health-care systems discourages Indigenous people from seeking care and engaging with health services. It increases the risk that Indigenous people will encounter racism when seeking care.

There are many documented instances of our health-care system’s failure to provide appropriate health care to Indigenous people, due to unfair assumptions and demeaning and dehumanizing societal stereotypes.

These health system failures discourage people from seeking care, and have resulted in death, as in the case of Brian Sinclair, who died after a 34-hour wait in a Winnipeg hospital emergency room in September 2008.

There can also be significant physical barriers to care for Inuit. Critical health services such as oncology specialists and treatments are often located in urban centres such as Ottawa, Winnipeg, Edmonton, Montréal and St John’s, thousands of kilometres away from remote communities in Inuit Nunangat. This leaves many Inuit negotiating stressful urban environments, dealing with cultural dislocation and navigating complex health systems without the benefit of community support networks.


People must fly out of remote communities for cancer treatment. (Alex Hizaka), Author provided

During our research, an Inuit peer support worker explained what it can be like for those who travel far from their family and community for their care:

“People come with no idea of why, and we are having to bridge two worlds for them. Often patients have no idea why health-care providers tell them to get on a plane, and then they think they are coming for treatment for three days and then it becomes two weeks. It is a tough situation as often people have no money, no support. People need to be able to explain their situation and how it is for them. People need to know that they are not alone.”

Research shows that these geographical challenges significantly impact access to health care and are often exacerbated by language barriers. Together these factors may make people vulnerable to additional harms unrelated to the health conditions for which they seek treatment.

Patients and health-care providers work together

Shared decision-making is an important evidence-informed strategy that holds the potential to promote patient participation in health decisions

In this model, health-care providers and patients work together using evidence-based tools and approaches and arrive at decisions that are based on clinical data and patient preferences — to select diagnostic tests, treatments, management and psycho-social support packages.

Shared decision-making is considered a high standard of care within health systems internationally and it has been found to benefit people who experience disadvantage in health and social systems.

Shared decision-making has also been found to promote culturally safe care, and has the potential to foster greater engagement of Inuit with their health-care providers in decision-making.

The concept of cultural safety was developed to improve the effectiveness and acceptability of health care with Indigenous people. Culturally safe care identifies power imbalances in health-care settings — to uphold self-determination and decolonization in health-care settings for Indigenous people.

The aim of a shared decision-making approach is to engage the patient in decision-making in a respectful and inclusive way, and to build a health-care relationship where patient and provider work together to make the best decision for the patient.

Most importantly, our approach has emphasized ways of partnering that align with the socio-cultural values of research partners and community member participants, both to develop tools and create approaches to foster shared decision-making. The term “shared decision-making” translates in Inuktitut to “Not Deciding Alone” and so that is the name of our project.

The results are outcomes that Inuit are more likely to identify as useful and relevant and that respect and promote Inuit ways, within mainstream health-care systems.

Self-determination through Inuit Qaujimajatuqangit

Our research uses the guiding principles of Inuit Qaujimajatuqangit — a belief system that seeks to serve the common good through collaborative decision-making — as the foundation for a strengths-based approach to promote Inuit self-determination and self-reliance.

Inuit Qaujimajatuqangit principles have been passed down from one generation to the next and are firmly grounded in the act of caring for and respecting others.

There is important learning taking place within academic and health-care systems that involves deepening understandings of what “patient-oriented care” means. We need to learn how to do research in partnership with those who are the ultimate knowledge users in cancer-care systems — patients.

In our work, Inuit partners and community members are leading the development of shared decision-making tools and approaches, building on their strengths and resiliency. Our research and health systems are beneficiaries of these partnerships that hold potential to create health care that is welcoming and inclusive for all.

With guidance and support from Inuit and more broadly, from Indigenous partners, we are learning how to take action on the TRC recommendations, and to make respect and kindness integral to best practice in research and health care.


Janet Jull, is an Assistant Professor in the School of Rehabilitation Therapy at Queen's University. Inuit Medical Interpreter Team is part of the Ottawa Health Services Network Inc.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The Conversation is seeking new academic contributors. Researchers wishing to write articles should contact Melinda Knox, Associate Director, Research Profile and Initiatives, at knoxm@queensu.ca.

International faculty and staff supports

The Human Rights & Equity Office is holding discussion sessions about developing and strengthening supports for employees coming to Queen's from abroad.

Staff and faculty participating in the first brainstorm meeting
Queen's faculty and staff participating in a brainstorming session about supports for international employees.

The Human Rights & Equity Office (HREO) recently invited international staff and faculty to engage in an initial conversation about what potential supports or groups could be created or strengthened to assist those moving from abroad for employment at Queen’s University.

A group of international faculty and staff gathered on Sept. 30 for a brainstorming session facilitated by Queen's Human Rights Advisor Nilani Loganathan, who guided the group in an exercise to begin to identify gaps in services and programs, and suggest ways that could better support international employees.

“I’m very pleased with the ideas brought forth by those who attended our first session,” says Loganathan. “We touched on a number of areas, including issues concerning relocating to Kingston, settling in at Queen’s, employment and education supports for families, and much more. We’re looking forward to continuing the conversation and collecting more feedback that will best inform our path forward.”

Employees who identify as international staff and faculty will have additional opportunities to provide their input. The next session is to take place on Friday, Nov. 15 in Mackintosh-Corry Hall, B176 from 12pm – 1pm. Please email hrights@queensu.ca to confirm your attendance.


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